Testicular Mapping And Its Co-Relation With Serum Hormonal Levels

Piyush  Agarwal; Kshirabdhi Tanaya  Panda; Vishal  Neniwal; Suresh Kumar  Rulaniya; D.Hota

doi:10.51168/sjhrafrica.v5i12.1499

Authors

Piyush Agarwal Assistant Professor, Department of General Surgery,Gouri Devi Institute of Medical Sciences and Hospital.
Kshirabdhi Tanaya Panda Senior Resident,Department of Pathology,SCB,Medical College and Hospital,Cuttack.
Vishal Neniwal Assistant Professor, Department of Urology, Government Medical College,Jhalawar,Rajasthan.
Suresh Kumar Rulaniya Consultant Urologist, Department of Urology, Apex Skyline Hospital,Jhunjhunu,Rajsthan.
D.Hota Ex HOD, Department of Urology, Scb Medical College,Cuttack, Odisha.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1499

Keywords:

Azoospermia, Nonobstructive Azoospermia, Obstructive Azoospermia, Hormonal Markers

Abstract

Background: Azoospermia, the complete absence of sperm in the ejaculate, is a major cause of male infertility, affecting 1% of men globally. It is categorized into obstructive azoospermia (OA) and non-obstructive azoospermia (NOA), with NOA being more prevalent and presenting challenges for sperm retrieval. Despite advances in techniques like intracytoplasmic sperm injection (ICSI), reliable markers for successful sperm retrieval in NOA remain unclear.

Aims: This study aims to evaluate histopathological abnormalities in azoospermic males and assess the efficacy of testicular mapping for sperm retrieval. It also focuses on the diagnostic value of serum inhibin B and other hormones in distinguishing OA from NOA.

Methods: The study will involve 25 male patients diagnosed with azoospermia, assessed through a compound testicular mapping procedure with 14 microbiopsies. Hormonal assessments (FSH, LH, testosterone, and inhibin B) will be conducted before and after the biopsy. Histopathological analysis will focus on confirming azoospermia, differentiating OA from NOA, and identifying focal spermatogenesis. Statistical analysis will correlate hormone levels with biopsy findings to evaluate diagnostic outcomes.

Results: The study analyzed 54 cases of azoospermia in men aged 20-39 years, with Nonobstructive Azoospermia (NOA) being more prevalent (74.1%) than Obstructive Azoospermia (OA) (25.9%). NOA cases were further classified into hypospermatogenesis, maturation arrest, and Sertoli cell only syndrome. Hormonal analysis revealed significant differences in serum LH, FSH, testosterone, and inhibin B levels across azoospermia subtypes, with serum inhibin B showing the highest sensitivity and specificity for differentiating OA and NOA. The findings underscore hormonal variability and the potential of inhibin B as a clinical marker for azoospermia classification.

Conclusion: The study highlights significant hormonal differences between obstructive and nonobstructive azoospermia subtypes, with serum Inhibin B emerging as the most reliable marker for differentiation.

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